The respiratory system during resuscitation: A review of the history, risk of infection during assisted ventilation, respiratory mechanics, and ventilation strategies for patients with an unprotected airway

Volker Wenzel, Ahamed H. Idris, Volker Dörges, Jerry P. Nolan, Michael J. Parr, Andrea Gabrielli, Angelika Stallinger, Karl H. Lindner, Peter J F Baskett

Research output: Contribution to journalArticle

67 Scopus citations


The fear of acquiring infectious diseases has resulted in reluctance among healthcare professionals and the lay public to perform mouth-to-mouth ventilation. However, the benefit of basic life support for a patient in cardiopulmonary or respiratory arrest greatly outweighs the risk for secondary infection in the rescuer or the patient. The distribution of ventilation volume between lungs and stomach in the unprotected airway depends on patient variables such as lower oesophageal sphincter pressure, airway resistance and respiratory system compliance, and the technique applied while performing basic or advanced airway support, such as head position, inflation flow rate and time, which determine upper airway pressure. The combination of these variables determines gas distribution between the lungs and the oesophagus and subsequently, the stomach. During bag-valve-mask ventilation of patients in respiratory or cardiac arrest with oxygen supplementation ( ≥ 40% oxygen), a tidal volume of 6-7 ml kg-1 ( ∼ 500 ml) given over 1-2 s until the chest rises is recommended. For bag-valve-mask ventilation with room-air, a tidal volume of 10 ml kg-1 (700-1000 ml) in an adult given over 2 s until the chest rises clearly is recommended. During mouth-to-mouth ventilation, a breath over 2 s sufficient to make the chest rise clearly (a tidal volume of ∼ 10 ml kg-1 ∼ 700-1000 ml in an adult) is recommended.

Original languageEnglish (US)
Pages (from-to)123-134
Number of pages12
Issue number2
StatePublished - Jan 1 2001



  • Bag-valve ventilation
  • Basic life support
  • CPR
  • Chest compressions
  • Gasping
  • Heart-arrest-therapy
  • Lung ventilation
  • Respiration - artificial
  • Stomach inflation
  • Unprotected-airway

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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